Deepthy Varghese, MSN, ACNP, FNP, Northside Hospital is joined by Sirena Bridges, MSN, FNP-BC, CCDS, VA Tennessee Valley Healthcare, and Jodie L. Hurwitz, MD, FHRS, North Texas Heart Center to discuss the effects of metoprolol and carvedilol on the risk of atrial tachyarrhythmia (ATA) and ventricular arrhythmia (VA) in over 4,000 heart failure (HF) patients with a primary prevention implantable cardioverter-defibrillator (ICD) by pooling data from five landmark ICD trials. Carvedilol treatment was associated with a 35% reduction in the risk of ATA and a corresponding decrease in the risk of inappropriate ICD shocks when compared to metoprolol. While there was a trend towards a lower risk of fast VA with carvedilol, this finding did not reach statistical significance. Carvedilol's unique properties, including its ability to block both β and α receptors, improve hemodynamics, and exhibit antiarrhythmic effects, may contribute to its superior outcomes. Overall, these results suggest that carvedilol may be preferred as the first-line beta-blocker choice in HF patients with a primary prevention ICD, but further prospective studies are needed to validate these findings and assess the impact of contemporary HF therapies on arrhythmic outcomes.
Article Authors and Podcast Contributors
Article Authors
Alexander Diamond, Ilan Goldenberg, Arwa Younis, Ido Goldenberg, Ramya Sampath, Valentina Kutyifa, Anita Y. Chen, Scott McNitt, Bronislava Polonsky, Jonathan S. Steinberg, Wojciech Zareba, and Mehmet K. Aktas
Podcast Contributors
Deepthy Varghese, MSN, ACNP, FNP, Northside Hospital
Sirena Bridges, MSN, FNP-BC, CCDS, VA Tennessee Valley Healthcare
Jodie L. Hurwitz, MD, FHRS, North Texas Heart Center
ACE Disclosure Policy
The Heart Rhythm Society is committed to the provision of Accredited Continuing Education (formerly known as Continuing Medical Education (CME)) that is balanced, objective, and evidence based. HRS adheres to the Standards for Integrity and Independence in Accredited Continuing Education of the Accreditation Council for Continuing Medical Education (ACCME) which require that those individuals in a position to control the content of an educational activity (including, but not limited to, planners, faculty, authors, committee members, content reviewers, editors, and staff) disclose all financial relationships with an ACCME-defined ineligible company* within the 24 months prior to the disclosure.
Any individual who refuses to disclose financial relationships is disqualified from participating in HRS ACE-certified activities. Owners and employees of ACCME-defined ineligible companies may have no role in the planning or implementation of ACE activities without a special written exemption from the HRS Chief Learning Officer that will be granted only in specific circumstances that meet ACCME requirements.
ACCME Definition:
*An ineligible company is one whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Examples of such organizations include:
- Advertising, marketing, or communication firms whose clients are ineligible companies
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All relevant financial relationships have been mitigated.
Host Disclosure(s):
D. Varghese: Nothing to disclose.
Contributor Disclosure(s):
S. Bridges: Nothing to disclose.
J. Hurwitz: Nothing to disclose.
Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner):
S. Sailor: No relevant financial relationships with ineligible companies to disclose.
S. Colbert: No relevant financial relationships with ineligible companies to disclose.
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The Heart Rhythm Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
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